Presence of apoptotic and nonapoptotic disseminated tumor cells reflects the response to neoadjuvant systemic therapy in breast cancer

INTRODUCTION: Neoadjuvant systemic therapy (NST) is an established strategy to reduce tumor size in breast cancer patients prior to breast-conserving therapy. The effect of NST on tumor cell dissemination in these patients is not known. The aim of this study was to investigate the incidence of disseminated tumor cells (DTC), including apoptotic DTC, in breast cancer patients after NST, and to investigate the correlation of DTC status with therapy response. METHODS: Bone marrow aspiration was performed in 157 patients after NST. DTC were detected by immunocytochemistry using the A45–B/B3 anticytokeratin antibody. To detect apoptotic DTC the antibody M30 (Roche Diagnostics, Germany) was used, which detects a neo-epitope expressed only after caspase cleavage of cytokeratin 18 during early apoptosis. RESULTS: The incidence of DTC in breast cancer patients was 53% after completion of NST. Tumor dissemination was observed more frequently in patients with no change/progressive disease (69%) than in patients with partial remission or complete remission of the primary tumor (46%) (P < 0.05). Ten out of 24 patients with complete remission, however, were still bone marrow positive. Apoptotic DTC were present in 36 of 157 (23%) breast cancer patients. Apoptotic cells only were detected in 14% of the patients with partial remission or complete remission, but were detected in just 5% of the patients with stable disease. Apoptotic DTC were detectable in none of the patients with tumor progression. CONCLUSION: The pathological therapy response in breast cancer patients is reflected by the presence of apoptotic DTC. Patients with complete remission, however, may still have nonapoptotic DTC. These patients may also benefit from secondary adjuvant therapy

Timing and Tempo of Early and Successive Adaptive Radiations in Macaronesia

The flora of Macaronesia, which encompasses five Atlantic archipelagos (Azores, Canaries, Madeira, Cape Verde, and Salvage), is exceptionally rich and diverse

Imagem corporal e comportamentos de risco para transtornos alimentares em bailarinos profissionais Body image and risk behavior for eating disorders in professional ballet dancers

INTRODUÇÃO E OBJETIVO: A grande preocupação com a aparência e a forma física e a constante pressão para manterem baixo peso corporal são fatores que levam a distorções da imagem corporal e tornam os bailarinos um grupo de risco para o desenvolvimento de transtornos alimentares (TA). O objetivo deste estudo foi avaliar a percepção da imagem corporal e sua associação com comportamentos de risco para TA em bailarinos profissionais. MÉTODOS: Foram estudados 61 bailarinos (39 mulheres e 22 homens) de uma instituição representante da elite do balé clássico brasileiro. A avaliação dos comportamentos de risco para TA foi feita com base nas versões em português dos questionários Eating Attitudes Test (EAT-26) e Bulimic Investigatory Test Edinburgh (BITE). A Escala de Silhuetas de Stunkard foi utilizada para avaliação da percepção da imagem corporal. A associação entre as variáveis foi avaliada com base na razão de prevalência (RP) e seus respectivos intervalos de confiança (IC) de 95%. RESULTADOS: Trinta e um bailarinos (50,8%) gostariam de ter a silhueta menor que a autopercebida como usual. A presença de comportamentos de risco para TA foi 2,71 vezes maior (IC 95% = 1,02 - 7,18) entre os que desejavam ter silhueta menor que a usual e 2,64 vezes maior (IC 95% = 1,20 - 5,80) entre aqueles que desejavam ter silhueta menor que a considerada mais saudável, quando comparados com os que estavam satisfeitos com a sua silhueta. CONCLUSÃO: A alta frequência de insatisfação com o corpo encontrada pode estar colaborando para ocorrência de comportamentos de risco para TA nos bailarinos investigados.<br>INTRODUCTION AND OBJECTIVE: Great concern with physical appearance and fitness as well as constant pressure in maintaining low body weight make ballet dancers a risk group for the development of eating disorders (ED). The objective of the present study was to evaluate the body image perception and its association with risk behavior for ED in professional ballet dancers. METHOD: Sixty-one dancers (39 women and 22 men) who represent the Brazilian classical ballet elite were assessed. The Portuguese versions of Eating Attitudes Test (EAT-26) and Bulimic Investigatory Test Edinburgh (BITE) questionnaires were used to evaluate de risk behavior for ED. Stunkard´s standard silhouettes were used to assess body image perception. Association between variables was evaluated through the prevalence ratio (PR) and respective 95% confidence interval (CI). RESULTS: Thirty-one dancers (50.8%) would like to have smaller silhouette than the usual. The presence of risk behavior for ED was 2.71 times higher (CI 95%=1.02-7.18) among those who would like to have smaller silhouette than the usual and 2.64 times higher (CI 95% = 1.20 - 5.80) among those who would like to have smaller silhouette than the ones considered healthier. CONCLUSION: The high frequency of body dissatisfaction found can be collaborating for the onset of risk behavior for ED in professional ballet dancers

Barriers and facilitators to mental health help-seeking for young elite athletes: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Adolescents and young adults experience a high level of mental disorders, yet tend not to seek help. Research indicates that there are many barriers and facilitators to help-seeking for young people in the general community. However there are limited data available for young elite athletes. This study aims to determine what young elite athletes perceive as the barriers and facilitators to help-seeking for common mental health problems.</p> <p>Methods</p> <p>Fifteen elite athletes aged 16–23 years each participated in one of three focus group discussions. In addition to written data, verbal responses were audio taped, transcribed and thematically analysed.</p> <p>Results</p> <p>Participants’ written and verbal data suggested that stigma was the most important perceived barrier to seeking help for young elite athletes. Other notable barriers were a lack of mental health literacy, and negative past experiences of help-seeking. Facilitators to help-seeking were encouragement from others, having an established relationship with a provider, pleasant previous interactions with providers, the positive attitudes of others, especially their coach, and access to the internet.</p> <p>Conclusions</p> <p>Intervention strategies for improving help-seeking in young elite athletes should focus on reducing stigma, increasing mental health literacy, and improving relations with potential providers.</p